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August 23, 1995

Systematic Reviews

Author Affiliations

Boston University School of Medicine Brookline, Mass

JAMA. 1995;274(8):657-658. doi:10.1001/jama.1995.03530080073047

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This book is a collection of papers presented at a meeting convened in 1993 to "discuss aspects of the science of reviewing clinical research." As such it suffers from the usual problems of published proceedings: a lack of cohesion combined with both inadequate coverage and redundancy. Most notably it offers virtually no theoretical foundation for the advocacy of systematic reviews. There is even a lack of clarity as to what is meant by the term.

"Systematic review" is preferred to "meta-analysis" because an overall summary statistic is not always attainable, but in many places in the text there is elision from the one term to the other. Meta-analysis, however, apparently remains the "gold standard." Yet hardly any distinction is made between the meta-analysis of controlled trials (for which the approach, conceptually, is of value) and of nonexperimental (observational) data (for which the approach is not valid at all).

The general

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